Bill Text: CA SB336 | 2011-2012 | Regular Session | Enrolled
Bill Title: Emergency room crowding.
Spectrum: Partisan Bill (Democrat 4-0)
Status: (Vetoed) 2012-09-28 - In Senate. Consideration of Governor's veto pending. [SB336 Detail]
Download: California-2011-SB336-Enrolled.html
BILL NUMBER: SB 336 ENROLLED
BILL TEXT
PASSED THE SENATE AUGUST 27, 2012
PASSED THE ASSEMBLY AUGUST 23, 2012
AMENDED IN ASSEMBLY AUGUST 21, 2012
AMENDED IN SENATE MAY 16, 2011
AMENDED IN SENATE MARCH 21, 2011
INTRODUCED BY Senators Lieu and De León
(Principal coauthor: Senator Alquist)
(Coauthor: Assembly Member Eng)
FEBRUARY 15, 2011
An act to add and repeal Section 1257.10 of the Health and Safety
Code, relating to health facilities.
LEGISLATIVE COUNSEL'S DIGEST
SB 336, Lieu. Emergency room crowding.
Existing law establishes various programs for the prevention of
disease and the promotion of health to be administered by the State
Department of Public Health, including, but not limited to, the
licensure and regulation of health facilities, including general
acute care hospitals. Violation of these provisions is a crime.
This bill would require every licensed general acute care hospital
with an emergency department to determine the range of crowding
scores, as defined, that constitute each category of the crowding
scale, as provided, for its emergency department. The bill would
require every licensed general acute care hospital with an emergency
department to calculate and record a crowding score every 4 hours,
except as specified, to assess the crowding condition of its
emergency department. The bill would require, by January 1, 2014,
every licensed general acute care hospital with an emergency
department to develop and implement a full-capacity protocol for each
of the categories of the crowding scale.
This bill would require every licensed general acute care hospital
with an emergency department to file its full-capacity protocol with
the Office of Statewide Health Planning and Development, and to
annually report revisions to its protocol. The bill would repeal its
provisions on January 1, 2017. By changing the definition of an
existing crime, this bill would impose a state-mandated local
program.
The California Constitution requires the state to reimburse local
agencies and school districts for certain costs mandated by the
state. Statutory provisions establish procedures for making that
reimbursement.
This bill would provide that no reimbursement is required by this
act for a specified reason.
THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:
SECTION 1. Section 1257.10 is added to the Health and Safety Code,
to read:
1257.10. (a) For purposes of this section, "crowding score" means
the score calculated using the following equation: 85.8 (total
number of patients within the emergency department/total number of
staffed beds in the emergency department, not to exceed the number of
licensed beds) + 600 (total number of admissions waiting in the
emergency department, including patients awaiting transfer/total
number of acute inpatient hospital beds routinely in use by the
hospital, excluding beds in the newborn nursery, neonatal intensive
care unit, and obstetrics) + 13.4 (total number of patients in the
emergency department admitted to the intensive care-critical care
unit, with a maximum of four) + 0.93 (the longest admit time, in
hours, including transfers) + 5.64 (the wait time for the last
patient waiting the longest in the waiting room, in hours) - 20.
(b) For purposes of this section, "crowding scale" means a range
of crowding scores that are divided into six categories of which
level one is the lowest level of crowding and level six is the
highest.
(c) Every licensed general acute care hospital, as defined in
subdivision (a) of Section 1250, with an emergency department shall
determine the range of crowding scores that constitute each category
of the crowding scale for its emergency department.
(d) (1) Except as otherwise provided in this subdivision, every
licensed general acute care hospital with an emergency department
shall calculate and record a crowding score a minimum of every four
hours to assess the crowding condition of its emergency department.
(2) If, after calculating and recording a crowding score as set
forth in paragraph (1), a licensed general acute care hospital does
not have a crowding score in level four or higher for the previous 30
days, it shall, notwithstanding paragraph (1), thereafter calculate
and record a crowding score every eight hours rather than every four
hours.
(3) If the licensed general acute care hospital that is
calculating and recording a crowding score every eight hours pursuant
to paragraph (2) records a score in level four or higher, it shall
immediately resume calculating and recording a crowding score at
least once every four hours as set forth in paragraph (1).
(4) Notwithstanding paragraphs (1) and (2), a licensed general
acute care hospital that has an emergency department census of less
than 14,000 visits annually shall calculate and record the crowding
score once daily between 4 p.m. and 8 p.m.
(e) Every licensed general acute care hospital with an emergency
department shall, by January 1, 2014, develop and implement, in
consultation with its emergency department staff, a full-capacity
protocol for each of the categories of the crowding scale that
addresses all of the following factors, as applicable:
(1) Notification of hospital administrators, nursing staff,
medical staff, and ancillary services of category changes on the
crowding scale.
(2) Hospital operations, including bed utilization, transfers,
elective admissions, discharges, supplies, and additional staffing.
(3) Emergency department operations, including diversion, triage,
and alternative care sites.
(4) The planned response of the organized medical staff for
rounds, discharges, coordination with the emergency department, and
emergency consults for emergency department patients.
(f) Every licensed general acute care hospital with an emergency
department shall file its full-capacity protocol with the Office of
Statewide Health Planning and Development and shall annually report
to the office any revisions to its protocol.
(g) This section shall remain in effect only until January 1,
2017, and as of that date is repealed, unless a later enacted
statute, that is enacted before January 1, 2017, deletes or extends
that date.
SEC. 2. No reimbursement is required by this act pursuant to
Section 6 of Article XIII B of the California Constitution because
the only costs that may be incurred by a local agency or school
district will be incurred because this act creates a new crime or
infraction, eliminates a crime or infraction, or changes the penalty
for a crime or infraction, within the meaning of Section 17556 of the
Government Code, or changes the definition of a crime within the
meaning of Section 6 of Article XIII B of the California
Constitution.
